| Entity Name: | DR CLAUDIUS GALEN THERAPY CENTER,INC |
| Jurisdiction: | FLORIDA |
| Filing Type: | Domestic Profit |
| Status: | Inactive |
| Date Filed: | 09 Nov 2010 (14 years ago) |
| Date of dissolution: | 29 Dec 2014 (10 years ago) |
| Last Event: | VOLUNTARY DISSOLUTION |
| Event Date Filed: | 29 Dec 2014 (10 years ago) |
| Document Number: | P10000092061 |
| FEI/EIN Number | 273814756 |
| Address: | 489 HIALEAH DRIVE, SUITE 10, HIALEAH, FL, 33010 |
| Mail Address: | 489 HIALEAH DRIVE, SUITE 10, HIALEAH, FL, 33010 |
| ZIP code: | 33010 |
| County: | Miami-Dade |
| Place of Formation: | FLORIDA |
| NPI | Enumeration Date | Last Update Date | Mailing Address | Practice Location Address | |||||||||||||||||||||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| 1093015471 | 2010-11-01 | 2012-02-17 | 489 HIALEAH DR STE 10, HIALEAH, FL, 330105320, US | 489 HIALEAH DR STE 10, HIALEAH, FL, 330105320, US | |||||||||||||||||||||||||||||||||||||
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| Phone | +1 786-953-6302 |
| Fax | 7869536664 |
Authorized person
| Name | MS. BARBARA MEDINA |
| Role | OWNER/PRESIDENT |
| Phone | 7866629188 |
Taxonomy
| Taxonomy Code | 174400000X - Specialist |
| License Number | OT 13096 |
| State | FL |
| Is Primary | Yes |
Other Provider Identifiers
| Issuer | MEDICAID |
| Number | 001958200 |
| State | FL |
| Issuer | NATIONAL PROVIDER IDENTIFIER( NPI) |
| Number | 1700042595 |
| State | FL |
| Issuer | MEDICAID |
| Number | 002900800 |
| State | FL |
| Name | Role | Address |
|---|---|---|
| MEDINA BARBARA | Agent | 3140 NW 53RD LANE, MIAMI, FL, 33142 |
| Name | Role | Address |
|---|---|---|
| MEDINA BARBARA | President | 489 HIALEAH DRIVE, HIALEAH, FL, 33010 |
| Event Type | Filed Date | Value | Description |
|---|---|---|---|
| VOLUNTARY DISSOLUTION | 2014-12-29 | No data | No data |
| REGISTERED AGENT ADDRESS CHANGED | 2014-11-04 | 3140 NW 53RD LANE, MIAMI, FL 33142 | No data |
| CHANGE OF PRINCIPAL ADDRESS | 2011-03-14 | 489 HIALEAH DRIVE, SUITE 10, HIALEAH, FL 33010 | No data |
| CHANGE OF MAILING ADDRESS | 2011-03-14 | 489 HIALEAH DRIVE, SUITE 10, HIALEAH, FL 33010 | No data |
| AMENDMENT | 2011-03-03 | No data | No data |
| Document Number | Status | Case Number | Name of Court | Date of Entry | Expiration Date | Amount Due | Plaintiff |
|---|---|---|---|---|---|---|---|
| J17000326589 | ACTIVE | 1000000745114 | MIAMI-DADE | 2017-06-01 | 2027-06-08 | $ 1,010.00 | STATE OF FLORIDA, DEPARTMENT OF REVENUE, MIAMI SERVICE CENTER, 8175 NW 12TH ST STE 119, DORAL FL331261828 |
| Name | Date |
|---|---|
| VOLUNTARY DISSOLUTION | 2014-12-29 |
| Reg. Agent Change | 2014-11-04 |
| ANNUAL REPORT | 2014-02-24 |
| ANNUAL REPORT | 2013-05-17 |
| ANNUAL REPORT | 2012-02-09 |
| ANNUAL REPORT | 2011-05-03 |
| Reg. Agent Change | 2011-03-14 |
| Amendment | 2011-03-03 |
| Domestic Profit | 2010-11-09 |
Date of last update: 01 Jan 2025
Sources: Florida Department of State
